RN Case Manager...........

[dreamrider_212]

I am a fairly new RN who has an LPN background in hospital nursing. I have now been offered a RN Case Manager position in a home health agency serving mostly Alterra/Stirling houses.

Can anyone give me some input as to the demands/workload etc of case management and any pitfalls etc to watch out for.

I havent accepted the position yet and would really appreciate some advice.

Thanks

[caliotter3]

I have only done the kind of case managing involved with being the primary nurse on a single case or the nurse who makes certain that everything is followed up on for the client and communicates everything important to the nurse supervisor and Director of Clinical Services.

The position that I believe you are describing I have found to be sorely lacking in several of the agencies that I have worked for. In other words, to put it bluntly, our nursing supervisors (or case managers) do not follow up on matters of importance. Not everything can be handled at the lowest rung of the ladder, although most nurses try to keep everything straight. Sometimes we need that voice of authority from the office. The best advice I could give you would be to start out by getting the charts of all the clients that you will be responsible for, writing down the bare essentials about each, write down the names of the nurses working the cases, and make home visits to introduce yourself to the clients and their families as soon as possible. Leave your business card and assure them that you are there to help resolve any issues. Ask them what they are having problems with at the present time and make note of this. You might want to hold an initial case conference for each client, one at a time, with mandatory attendance from the nurses on the case and get input from these nurses. You can take this time to let the nurses know what your expectations are and where you expect to fill in. Offer to be a resource for any of their problems. That's about what I would expect to do if I were ever to get a job as a case manager. Perhaps you can get responses from persons who are already filling that function at agencies. Good luck and hope you like the job.

[ragtopnurse]

I have been in HomeCare for 7 yrs but I have recently been thinking about case management myself. Our company doesn't have such positions so I would love to hear what you think of it if you take this position. If anyone else can tell me how to pursue this area I would love to your suggestions. Thanks

[wonderbee, BSN, RN]

I would ask what is meant by case management. I see it means different things depending on the agency. Get a good job description.

At my agency, the case manager is the primary nurse who does the admission, the visits, the discharges, resumptions of care and transfers. Our Director of Clinical Services is primarily a data entry nurse who takes our raw paperwork and enters it into the system. She supervises when questions arise and oversees the schedules and answers to the director. She does not do case management.

I left case management recently. There were days when the discharges were coming fast and furious and admissions were coming at least one a day. I couldn't keep up with the piles of paperwork.

[colleennurse, ASN, RN]

Case management at the agency I work for means that you get a case load of patients and you manage their care and make the visits to see them. You decide when to do the visits (of course within compliance of orders) and you contact MDs when necessary, you can initiate referals to PT/OT/RD. The case manager also determines when the pt is ready for DC from the agency, is responsible for recertifications, and other types of ppwk/computer work if patient is transferred to the hospital and such. If you have to float visits to another nurse, you should get report on those patients. Sounds like you will be what my agency refers to as a congregate nurse, where your patients reside at ACFs and the such.